(Active Members and Non-Medicare Retirees)
The State Health Plan’s Board of Trustees, under the leadership of State Treasurer Dale R. Folwell, CPA, recently approved changes to the State Health Plan. The benefit changes are effective for the benefit plan year beginning January 1, 2018. The benefit changes are designed to provide Plan members with stability and predictability in their benefits and begin the task of lowering the state’s $42 billion in unfunded liabilities for retiree health benefits.
There are also updates for separate programs that take effect immediately. No decisions were made regarding plan options for Medicare retirees. Any decisions regarding those options will not be made until later this summer to coincide with UnitedHealthcare’s rate renewal.
The Board of Trustees approved the following benefit changes effective January 1, 2018:
Freezing family health care premiums
  • This is an initial step to improving the affordability of Plan benefits for families. Unlike many other states, North Carolina does not subsidize dependent care coverage, resulting in 80 percent of Plan members choosing individual coverage.
Eliminating the Consumer-Directed Health Plan (CDHP 85/15)
  • This will reduce complexity and provide long-term financial stability. This plan is known as the “richest” and, as such, presents a significant liability to the state. Please note: Because the CDHP is being eliminated, the Health Reimbursement Accounts (HRA) will not rollover for use in 2018.  The HRA funds will only be available for claims incurred in 2017 and submitted for processing before March 31, 2018. 
Reducing the wellness premium credit activities from three activities to one, and only keeping the tobacco attestation activity
  • This is designed to reduce complexity and minimize the potential for members to make a mistake during enrollment which may lead to higher premiums.
Setting employee-only base premiums for the Traditional 70/30 Plan at $25 per month, and for the Enhanced 80/20 Plan at $50 per month
  • This puts North Carolina more in line with other, comparable states and creates a more balanced approach for spreading cost increases across the population and promoting long-term financial stability. Non-Medicare retirees will not be required to complete the tobacco attestation or pay a premium for the Traditional 70/30 plan.

Program Updates

The Plan is constantly evaluating and realigning programs to provide the best return on investment as well as reduce complexities and build value for all health plan members. The following changes were also recently announced:
Discontinuing the Stork Rewards maternity incentive program
  • No new members may enroll. Those members who enrolled by March 31, 2017, and who meet the criteria to receive the incentive will be able to do so. However, the Plan will continue to offer maternity coaching available through NC HealthSmart.
Discontinuing to subsidize the cost of the Diabetes Prevention Program and Eat Smart, Move More, Weigh Less (ESMMWL) for its members
  • Plan members will continue to have lifestyle coaching available through our population health management program, NC HealthSmart. Members may also visit a local in-network dietitian to discuss their risk for diabetes or receive assistance with weight management, as allowed under their benefit plan.
The Plan has several online resources for members, like the Diabetes Resource Center. The Plan will continue to provide resources and information through our monthly newsletter Member Focus.